The five-box method: The "four-box method" for the Catholic physician.

Background/hypothesis: The traditional ethical model of the "Four-Box Method" can be adapted to integrate the perspective of a Catholic physician. In an increasingly secularist environment, medical students and physicians are often asked to "leave religious beliefs at the door" and not consider the care and stewardship of our own morality and involvement as a provider. We reject this view. A patient's own religious and moral beliefs should be respected to the extent that they do not destroy our own; for us, the Catholic viewpoint can shine a light into dark corners and aid us in translating true things to patients of any religion.

Methods: We analyzed a sample case in five different categories: medical indications, patient preferences, quality of life, contextual features, and the Catholic context. We explored how to methodically integrate the perspective of a Catholic physician into the analysis of this case to make the best decision for the patients.

Results/discussion: We felt that we were successfully able to integrate this perspective and create a "fifth box" based on the principles of Catholic social teaching. There were also points during the analysis that the perspective of the Catholic physician was integrated into the discussion of medical indications, proving to us that the "Catholic perspective" cannot be just put in one box either.

Lay Summary: The traditional ethical model of the "four-box method" can be adapted to integrate the perspective of a Catholic physician. In an increasingly secularist environment, medical students and physicians are often asked to "leave religious beliefs at the door" and not consider the care and stewardship of our own morality and involvement as a provider. We reject this view. A patient's own religious and moral beliefs should be respected to the extent that they do not destroy our own; for us, the Catholic viewpoint can shine a light into dark corners and aid us in translating true things to patients of any religion. By expanding to a "fifth box" of Catholic social teaching, the Catholic physician finds a way to methodically analyze an ethical scenario. This case study is an example of this type of "five-box" analysis.